TY - JOUR
T1 - Modified creatinine index and risk for long-term infection-related mortality in hemodialysis patients
T2 - ten-year outcomes of the Q-Cohort Study
AU - Arase, Hokuto
AU - Yamada, Shunsuke
AU - Hiyamuta, Hiroto
AU - Taniguchi, Masatomo
AU - Tokumoto, Masanori
AU - Tsuruya, Kazuhiko
AU - Nakano, Toshiaki
AU - Kitazono, Takanari
N1 - Funding Information:
We would like to thank all the doctors and medical staff who participated in the Q-Cohort Study. The following personnel (institutions) participated in this trial: Takashi Ando (Hakozaki Park Internal Medicine Clinic); Takashi Ariyoshi (Ariyoshi Clinic); Kouichiro Goto (Goto Clinic); Fumitada Hattori (Nagao Hospital); Harumichi Higashi (St Mary’s Hospital); Tadashi Hirano (Hakujyuji Hospital); Kei Hori (Munakata Medical Association Hospital); Takashi Inenaga (Ekisaikai Moji Hospital); Hidetoshi Kanai (Kokura Memorial Hospital); Shigemi Kiyama (Kiyama Naika); Tetsuo Komota (Komota Clinic); Hiromasa Kuma (Kuma Clinic); Toshiro Maeda (Kozenkai-Maeda Hospital); Junichi Makino (Makino Clinic); Dai Matsuo (Hirao Clinic); Chiaki Miishima (Miishima Naika Clinic); Koji Mitsuiki (Japanese Red Cross Fukuoka Hospital); Kenichi Motomura (Motomura Naika Clinic); Sadatoshi Nakamura (Kokura Daiichi Hospital); Hidetoshi Nakamura (Kokura Daiichi Hospital); Koichi Nakashima (Ohashi Internal Circulatory Clinic); Nobumitsu Okita (Shiroishi Kyoritsu Hospital); Shinichiro Osato (Osato Jin Clinic); Sakura Sakamoto (Fujiyamato Spa Hospital); Keiko Shigematsu (Shigematsu Clinic); Kazumasa Shimamatsu (Shimamatsu Naika Iin); Yoshito Shogakiuchi (Shin-Ai Clinic); Hiroaki Takamura (Hara Hospital); Kazuhito Takeda (Iizuka Hospital); Asuka Terai (Chidoribashi Hospital); Hideyoshi Tanaka (Mojiko-Jin Clinic); Suguru Tomooka (Hakozaki Park Internal Medicine Clinic); Jiro Toyonaga (Fukuoka Renal Clinic); Hiroshi Tsuruta (Steel Memorial Yawata Hospital); Ryutaro Yamaguchi (Shiseikai Hospital); Taihei Yanagida (Saiseikai Yahata General Hospital); Tetsuro Yanase (Yanase Internal Medicine Clinic); Tetsuhiko Yoshida (Hamanomachi Hospital); Takahiro Yoshimitsu (Gofukumachi Kidney Clinic, Harasanshin Hospital); Koji Yoshitomi (Yoshitomi Medical Clinic). We thank Robert Blakytny, PhD, from Edanz Group (www. edanzediting.com/ac) for editing a draft of this manuscript. The Q-Cohort Study is supported by The Kidney Foundation, Japan (JKFB07-13, JKFB08-8, JKFB11-11) and The Japan Dialysis Outcome Research Foundation (076-02), without restriction on publications.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Modified creatinine (Cr) index, calculated by age, sex, pre-dialysis serum Cr concentration, and Kt/V for urea, is an indicator of skeletal muscle mass in hemodialysis (HD) patients. It remains unknown whether the modified Cr index predicts infection-related mortality in this population. We investigated the association between the modified Cr index and infection-related mortality. A total of 3046 patients registered in the Q-Cohort Study, a multicenter, observational study of HD patients, were analyzed. Associations between sex-specific quartiles (Q1–Q4) of the modified Cr index and the risk for infection-related mortality were analyzed by Cox proportional hazard model. During a median follow-up of 8.8 years, 387 patients died of infection. The estimated risk for infection-related mortality was significantly higher in the lower quartiles (Q1, Q2, and Q3) than in the highest quartile (Q4) as the reference group (hazard ratios and 95% confidence intervals [CI]: Q1, 2.89 [1.70–5.06], Q2, 2.76 [1.72–4.62], and Q3, 1.79 [1.12–2.99]). The hazard ratio (95% CI) for a 1 mg/kg/day decrease in the modified Cr index was 1.18 (1.09–1.27, P < 0.01) for infection-related mortality. In conclusion, a lower modified Cr index is associated with an increased risk for long-term infection-related mortality in the HD population.
AB - Modified creatinine (Cr) index, calculated by age, sex, pre-dialysis serum Cr concentration, and Kt/V for urea, is an indicator of skeletal muscle mass in hemodialysis (HD) patients. It remains unknown whether the modified Cr index predicts infection-related mortality in this population. We investigated the association between the modified Cr index and infection-related mortality. A total of 3046 patients registered in the Q-Cohort Study, a multicenter, observational study of HD patients, were analyzed. Associations between sex-specific quartiles (Q1–Q4) of the modified Cr index and the risk for infection-related mortality were analyzed by Cox proportional hazard model. During a median follow-up of 8.8 years, 387 patients died of infection. The estimated risk for infection-related mortality was significantly higher in the lower quartiles (Q1, Q2, and Q3) than in the highest quartile (Q4) as the reference group (hazard ratios and 95% confidence intervals [CI]: Q1, 2.89 [1.70–5.06], Q2, 2.76 [1.72–4.62], and Q3, 1.79 [1.12–2.99]). The hazard ratio (95% CI) for a 1 mg/kg/day decrease in the modified Cr index was 1.18 (1.09–1.27, P < 0.01) for infection-related mortality. In conclusion, a lower modified Cr index is associated with an increased risk for long-term infection-related mortality in the HD population.
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U2 - 10.1038/s41598-020-58181-6
DO - 10.1038/s41598-020-58181-6
M3 - Article
C2 - 31988325
AN - SCOPUS:85078456500
SN - 2045-2322
VL - 10
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 1241
ER -